Abstract
BackgroundEstablishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice.MethodsWe analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification.ResultsIt was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine.ConclusionRevisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.
Highlights
Establishing and managing a board certification system is a common concern for many countries
The purpose of this study was to investigate the current status of board certification in internal medicine, identify factors associated with the maintenance of board certification, and to analyze change of practice area when internal medicine specialists left hospitals to practice in clinics
Logistic regression showed that the odds of maintaining board certification were lower in women and those working at locations other than academic hospitals, and higher in those who practiced a subspecialty of internal medicine (Table 3)
Summary
Establishing and managing a board certification system is a common concern for many countries. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. The establishment and management of a board certification system is a common concern for many countries. Common issues are the quality of care [1,2,3], requirements and conditions of specialty certification, In Japan, the board certification system has developed and has operated by respective academic societies; it is not directly linked to reimbursement systems and it is not mandatory hospitals and clinics to be staffed by board certified medical practitioners. The Ministry of Health, Labour and Welfare reported that 56.9% of medical practitioners had one or
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